[Review of Das Krankheitsbild der Apraxie ('motorischen Asymbolie')--auf Grund eines Falles von einseitiger Apraxie and On Apraxia]
Liepmann has recently reported the autopsy findings of his famous case of one-sided apraxia. The importance of his observations is such as to warrant a review 6i the whole work at this somewhat late date. There is no contribution to neurology of late years that deserves so well to be put forth as a model of careful study of nature's experiments as this one. Nor can we point to any better instance of the remarkable influence of Wernicke's teachings. " That a man can act with his right
... is right extremities as if he were deeply demented, as if he understood neither questions nor orders, as if he could grasp neither the meaning of objects, nor the sense of print or writing, while he can show with his left extremities that all these apparently absent functions are present, has not been described so far." The patient in question, born in 1852, an official with University training, had had syphilis about 1880, transitory fainting spell during the summer of 1899, an< * finally on December 2,1899, a sudden attack which made him aphasic and produced a condition which for ten weeks was considered as one of ' aphasia with profound dementia following apoplexy' in one of the Berlin hospitals. He was transferred to a hospital for the insane. The peculiarity was that the patient obeyed all requests which implied the use of the body as a whole; he would rise, would go to the window, to the door. When asked to pick up and show the use of some objects before him, he blundered in every attempt, acted perversely, and made odd movements with the right arm. When the right arm -was held and he had to use the left, he correctly picked out cards which he could not do with the right; movements of the foot could be imitated with the left but not with the right foot. When the right side was inhibited the appearance of dementia was stopped and the patient could be examined. There evidently existed motor confusion and perplexity on the habitually used right side and inability to spontaneously use the left capable side. The right side would at once fumble and distract hopelessly. A careful study demonstrated a typical right-sided apraxia, not merely dependent on defective recognition of the objects. The aphasia was purely motor-orders were understood, also conversation.